Recommendation on an updated standardization of serum magnesium reference ranges

Abstract

Purpose Serum magnesium is the most frequently used laboratory test for evaluating clinical magnesium status. Hypomagnesemia (low magnesium status), which is associated with many chronic diseases, is diagnosed using the serum magnesium reference range. Currently, no international consensus for a magnesemia normal range exists. Two independent groups designated 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L) as the low cut-off point defining hypomagnesemia. MaGNet discussions revealed differences in serum magnesium reference ranges used by members' hospitals and laboratories, presenting an urgent need for standardization. Methods We gathered and compared serum magnesium reference range values from our institutions, hospitals, and colleagues worldwide. Results Serum magnesium levels designating "hypomagnesemia" differ widely. Of 43 collected values, only 2 met 0.85 mmol/L as the low cut-off point to define hypomagnesemia. The remainder had lower cut-off values, which may underestimate hypomagnesemia diagnosis in hospital, clinical, and research assessments. Current serum magnesium reference ranges stem from "normal" populations, which unknowingly include persons with chronic latent magnesium deficit (CLMD). Serum magnesium levels of patients with CLMD fall within widely used "normal" ranges, but their magnesium status is too low for long-term health. The lower serum magnesium reference (0.85 mmol/L) proposed specifically prevents the inclusion of patients with CLMD. Conclusions Widely varying serum magnesium reference ranges render our use of this important medical tool imprecise, minimizing impacts of low magnesium status or hypomagnesemia as a marker of disease risk. To appropriately diagnose, increase awareness of, and manage magnesium status, it is critical to standardize lower reference values for serum magnesium at 0.85 mmol/L (2.07 mg/dL; 1.7 mEq/L).

The Role of Hypomagnesemia in Cardiac Arrhythmias: A Clinical Perspective

“…Half of the significant hypokalemias seem to be associated with magnesium deficiency; the co-administration of magnesium thus is essential in correcting serum potassium (K+) concentrations [ 27 ]. Enhanced gastrointestinal and renal excretion of K+ can also lead to hypokalaemia; however, it was shown that in patients with both hypomagnesemia and hypokalaemia, the repletion of Mg 2+ alone also increased the serum K+ level [ 4 , 28 ].…”

“…To date, monitoring magnesemia may be challenging, especially since there are no available standardized protocols for serum magnesium measurement in different patient populations or the general population. There are no evidence-based reference range values to date, but rather only a consensus-based cut-off value for defining hypomagnesemia, established at 0.85 mmol/L (2.07 mg/dL or 1.7 mEq/L) [ 4 ]. For serum measurement of Mg 2+ concentrations, the blood samples should be accurately prepared to avoid hemolysis since the magnesium stored in the erythrocytes exceeds serum magnesium [ 106 ].…”

“…The lower cut-off limit of normal magnesemia is set differently by various studies. However, a recently standardised agreed normal value of serum magnesium is 0.85–2.3 mg/dL [ 4 ]. There is an important limitation of these methods linked to the ability of Mg 2+ to keep serum concentration within normal limits due to and at the cost of intracellular depletion [ 5 ].…”

“…This classification introduces two new subclasses (asymptomatic hypomagnesemia and chronic latent deficiency). The new subclasses increase the accuracy of establishing magnesium status and correcting hypomagnesemia from early stages as it is known to date that chronic latent magnesium deficiency increases susceptibility to disease [ 4 , 7 ].…”

Anti-Aging und Mikronährstoffe – eine Auswahl an Anti-Seneszenz-Nutrienten

“…B. 8-OH-dG) beitragen und fördert dadurch allgemein die zellulärer Seneszenz, die Atherogenese sowie die Alterung des kardiovaskulären Systems 34 35 36 37 38 39 .…”